Hormone-induced and spontaneous regression of metastatic renal cancer

Abstract

Ten publications between 1964 and 1971 suggest that tumor regression can be induced by hormone therapy in a limited number of patients with metastatic renal cancer. Subjective improvement occurs in about 50% of treated cases. Of 272 collected cases from the various reports (including a personal series of 80) who were treated with progestins or androgens, the overall objective response rate was 15%, the range being 6%-33%. In the present author's series, if gravely-ill patients who died within 6 weeks are excluded, tumor regression was seen in 22% of cases, and in 27 of the men. Objective improvement is usually evident within 2 to 6 weeks of commencing treatment. Although the response is usually incomplete, or of limited duration, hormone therapy may offer a new lease of life to seriously ill and elderly patients for up to 2 or 3 years. Special consideration is given to spontaneous regression as a possible explanation for the responses observed during hormone administration. From the available evidence it is concluded that this treatment, and not a coincidental natural event, is responsible for the improvement.